Provider Demographics
NPI:1679267827
Name:CARTER, JENNIFER MARIE KUUIPO (MM)
Entity type:Individual
Prefix:
First Name:JENNIFER MARIE
Middle Name:KUUIPO
Last Name:CARTER
Suffix:
Gender:F
Credentials:MM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10075
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96721-5075
Mailing Address - Country:US
Mailing Address - Phone:808-896-3473
Mailing Address - Fax:
Practice Address - Street 1:15-1331 22ND AVENUE
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749
Practice Address - Country:US
Practice Address - Phone:808-896-3473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker